Badelon O
Hôpital Robert-Debré, Paris.
Rev Prat. 1998 Oct 15;48(16):1805-11.
The diagnosis approach after knee injury in children must be carefully taken care of the growth plates but it is necessary to emphasize the frequency of the ligament and intra-articular lesions, and on the other hand to consider their benign reputation. Clinical and conventional radiologic examination give in most of the cases the correct diagnosis. For the others an examination under general anesthesia ++ is necessary to distinguish the ligament and the growth plate lesions. MRI must not replace the arthroscopy which is necessary for an haemarthrosis with a stable knee or a little isolated anterior instability. The non-surgical treatment is indicated for benign sprain and non-displaced or mid-displaced fractures if the reduction is perfect and stable. All the other lesions need a surgical treatment which must be the most conservative as possible, especially for the meniscus, because their integrity is a guarantee for the quality of the long term result.
儿童膝关节损伤后的诊断方法必须谨慎对待生长板，但有必要强调韧带和关节内损伤的发生率，另一方面要考虑到它们相对良性的特点。临床和传统放射学检查在大多数情况下能做出正确诊断。对于其他情况，全身麻醉下的检查++对于区分韧带和生长板损伤是必要的。MRI不能替代关节镜检查，对于膝关节稳定或仅有轻微孤立性前向不稳定的关节积血，关节镜检查是必要的。对于良性扭伤以及无移位或中度移位骨折且复位完美稳定的情况，可采用非手术治疗。所有其他损伤都需要手术治疗，手术必须尽可能保守，尤其是对于半月板，因为其完整性是长期疗效质量的保证。
